title: Acute interventional recanalisation of vertebrobasilar stenoses by angioplasty: complications and 12 months follow up.
abstract: BACKGROUND
  In acute symptomatic vertebrobasilar artery stenosis, the use of mechanical recanalisation remains controversial. The complication rate of acute interventional recanalisation (aIR) has to be considered, as evidence from randomised trials is lacking. In a single centre retrospective case series, we here describe complications and outcome after aIR.
  
  
  METHODS
  We retrospectively assessed aIR in a tertiary care centre and included the following parameters: indication for aIR, national institute of health stroke scale (NIHSS) score on admission, recanalisation by thrombolysis in myocardial infarction score (TIMI) grades, post-interventional complications, mortality, NIHSS and modified Rankin scale at follow-up and rate of restenosis.
  
  
  RESULTS
  We identified 14 aIR (14 percutaneous transluminal angioplasty with or without stent implantation in 12 patients; 6/12 with thrombolysis; n = 6 vertebral artery, n = 8 basilar artery; 4 women, mean age 67 years). Mortality was 25 % (3/12) after 7 days and 42 % (5/12) after 12 months. In 12/14, interventions are complete (TIMI 3, 86 %), in 2/14, a partial recanalisation (TIMI 2, 14 %) was achieved. In one case, a peri-interventional fatal intracerebral haemorrhage occurred (1/12, 8 %). At late follow-up (mean 342 days), one re-occlusion (1/7, 14 %) and one recurrent stroke (1/12, 8 %) were observed.
  
  
  CONCLUSIONS
  In our single centre series of vertebrobasilar aIR recanalisation rate was high. However, procedural safety and clinical outcome varied considerably. The results of aIR need to be assessed in multicentric registers to define the procedural risk and outcome in the clinical setting.
authors.affiliation: Department of Neurology, University of Cologne, Cologne, Germany.
authors.forename: C M
authors.initials: CM
authors.lastname: Kowoll
authors.forename: W
authors.initials: W
authors.lastname: Moeller-Hartmann
authors.forename: G R
authors.initials: GR
authors.lastname: Fink
authors.forename: W F
authors.initials: WF
authors.lastname: Haupt
authors.forename: J
authors.initials: J
authors.lastname: Sobesky
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000009:adverse effects* / Q000379:methods*; D002548:Cerebral Revascularization / Q000009:adverse effects* / Q000379:methods*; D003251:Constriction, Pathologic / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome; D014715:Vertebrobasilar Insufficiency / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*